Definition:

Collection of exudative serous fluid inside the pleural sac is known as Pleural Effusion.

Aetiology:

(1) Tubercular focus in the lungs or pleura.

(2) Rheumatism

(3) Lobar and bronchopneumonia

(4) Infarction of the lung.

(5) Bronchogenic carcinoma.

(6) Trauma.

(7) Viral infection Clinical Features: Onset is usually insidious.

Symptoms:

(I) History of dry pleurisy may be present.

(2) Chest pains or felt heavier.

(3) Dyspnoea.

(4) Fever, anorexia, weakness, fatigue etc. may be present.

Signs

(1) Temperature 101°F or above (2) Pulse— tachycardia (3) Distressed on exertion. (4) Hurried respiration. (5) Cyanosis may be present. (6) On examination of chest :—( a) Inspection of illness and restricted movement on the affected side. Shift of the mediastinum to the opposite side. (b) Palpation diminished expansion on the affected side; the cardiac apex is moved away from the fluid. (c) Percussion—Stony dullness over the effusion, above the fluid level a high-pitched note may be elicited. Obliteration of Traube’s space: if left sided effusion. (D) Auscultation breath sound and vocal resonance: absent or diminished. Bronchial breathing at the level of pleural effusion due to relaxed lung,

Investigations:

(1). Aspirated pleural fluid shows all characters of exudates. (2) E.S.R. is raised. (3) X-ray of chest (P.A. view)—A dense homogeneous opacity obliterating the cardiophrenic angle.

Differential Diagnosis:

(1) Thickened pleura. (2) Lobar conso1idation. (3) Fibrosis and collapse. (4) Empyema. (5) Malignant neoplasm.

(1) Permanent collapse of the lung. (2) Pleural thickening, adhesions and Bronchiectasis. (3) In case of tuberculous effusion, pulmonary tuberculosis may occur within 4-5 years.

Treatment:

(1) Complete rest in be d, adequate nutrition, vitamins. (2) Aspiration of pleural fluid by two way canula. (3) Chest physiotherapy to encourage expansion of lower chest. (4) Aspirin, Salicylate or other non steroidal anti inflammatory drugs may be given. (5) Anti-tuberculous drugs for a specified period in tuberculous cases may be helpful.